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Francine R. Digitally signed by Francine
<br />R. R. Villareal
<br />Villareal Date: 2020.10.0609:13:10
<br />DT 00'
<br />ACOR& CERTIFICATE OF LIABILITY INSURANCE
<br />III
<br />DAT7/17/2020 Y)
<br />0/17/020
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />MCGRIFF, SEIBELS & WILLIAMS, INC.
<br />P.O. Box 10265
<br />Birmingham, AL 35202
<br />CONTACTout
<br />NAME:PHONE
<br />800-47 FAX
<br />A/C N-22
<br />o Ext: Me No:
<br />ADDRESS: Maul@mcgriff.com
<br />INSURERS) AFFORDING COVERAGE
<br />NAIL#
<br />INSURER A:Atlantic Specialty Insurance Company
<br />27154
<br />INSURED
<br />ARC Document Solutions, Inc.
<br />INSURER B:Travelers Property Casualty Company ofAmedca
<br />25674
<br />INSURER C :The Travelers Indemnify Company
<br />25658
<br />345 Clinton Street
<br />Costa Mesa, CA 92626
<br />INSURER D
<br />INSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER:EVJ86YAH REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADOL
<br />SD
<br />SUBR
<br />MD
<br />POLICY NUMBER
<br />POLICYEFF
<br />MMIDD/YYYY
<br />POLICY EXP
<br />MMIDD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />7110166080001
<br />02/26/2020
<br />02/26/2021
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TOR PREMISES Ea occurrence
<br />$ 100,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL a ADV INJURY
<br />$ 1,000,000
<br />X
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO- ❑ LOC
<br />JECT
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS-COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />7110166080001
<br />02/26/2020
<br />02/26/2021
<br />COMBINEDSINGLE LIMIT
<br />Ea accident)
<br />1,000,000
<br />X'
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accitlent
<br />( )
<br />$
<br />HIRED N NO
<br />AUTOS ONLY AUTOS ONLY
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />7110166080001
<br />02/26/2020
<br />02/26/2021
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />5,000.000
<br />EXCESS IAB
<br />CLAIMS -MADE
<br />XRDETENTION$
<br />$
<br />B
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY Y/N
<br />UB2L7502841951K((AOS)
<br />UB2L6010821951 R (AZ, MA, WI)
<br />02/26/2020
<br />02/26/2021
<br />PER OTH-
<br />X STATUE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />ANY PROPRIETORIPARTNER/EXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />E.L. DISEASE - EA EMPLOYEE
<br />S 1,000.000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />S
<br />S
<br />$
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Re: Reprographic Services.
<br />City of Santa Ana, its officers, agents and employees are Additional Insured under General Liability which applies on a primary and non-contributory, basis as required by
<br />written contract. In the event of cancellation by the insurance companies, the policies have been endorsed to provide 30 days notice of cancellation (except for non
<br />payment) to the certificate holder as required by written contract.
<br />CERTIFICATE HOLDER
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Page 1 of 5 ©1988-2015
<br />ittax n'tknkgemenx vnTelan
<br />REVIEWED&APPROVED BY: p, MIUld
<br />Risk Management Analyst
<br />ACORD 25 (2016103)
<br />The ACORD name and logo are registered marks of ACORD
<br />
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